An investigation into the present status and influencing factors of nurse retention in grade-a tertiary general hospitals in Shanxi Province within the framework of the magnet hospital concept

BACKGROUND

The attrition of nursing staff significantly contributes to the shortage of healthcare professionals. This study entailed an examination of the propensity of nurses to sustain employment within Grade-A tertiary general hospitals and the various influencing factors.

METHODS

A total of 2,457 nurses from three grade-A tertiary general hospitals were surveyed. The survey instruments included a general information questionnaire, a scale measuring their willingness to continue working, and a Chinese version of the Magnet Hospital Factor scale.

RESULTS

The scores of the willingness to continue working scale and the Magnet Hospital Factor scale were 21.53 ± 4.52 and 145.46 ± 25.82, respectively. There were statistically significant differences in the scores of willingness of nurses to continue working across various factors, including the department, age, marital status, family location, length of service as nurses, professional title, position, and employment type, upon comparison (P < 0.001). The correlation analysis showed that there was a positive correlation between the willingness of nurses to continue working and the magnet hospital factors, with a correlation coefficient of 0.523 (P < 0.01). Regression analysis showed that department, length of service as nurses, professional title, position, average monthly income, number of night shifts, medical care relationship, educational support, and nursing manager support among the magnet hospital factors were important predictors of willingness to continue working (P < 0.001).

CONCLUSION

The willingness of nurses to continue working in grade-A tertiary general hospitals in Shanxi Province was determined to be at an upper-middle level. The magnet status of grade-A tertiary general hospitals needs to be improved, and there are many factors that influenced willingness of nurses to continue working. To cultivate a more favorable environment and bolster nurse recruitment and retention, all healthcare institutions should strive to establish a magnet nursing environment, thereby fostering the robust development of the nursing team.

Decreased plasma IL-22 levels and correlations with IL-22-producing T helper cells in patients with new-onset systemic lupus erythematosus

Interleukin-22 (IL-22) and IL-22-producing T helper (Th) cells are involved in the pathogenesis of autoimmune diseases. However, the roles of IL-22 and IL-22-producing T helper cells in systemic lupus erythematosus (SLE) remain unclear. Plasma levels of IL-22 were measured in 41 patients with SLE (19 new-onset and 22 relapsing patients) and 20 healthy controls by enzyme-linked immunosorbent assay (ELISA). Meanwhile, the percentages of CD4(+) IFN-γ(+) (Th1), CD4(+) IL-17(+) (Th17) and CD4(+) IFN-γ(-) IL-17(-) IL-22(+) (Th22) cells in peripheral lymphocytes were determined by flow cytometry, and plasma IL-22 autoantibodies were detected by ELISA in 19 new-onset SLE patients and 20 healthy controls. Plasma IL-22 levels in new-onset SLE patients were significantly decreased compared with relapsing SLE patients and healthy controls. After treatment with prednisone and hydroxychloroquine, the levels of plasma IL-22 in new-onset SLE patients were obviously increased but still lower than healthy controls. There was a positive correlation between plasma IL-22 levels and the percentages of Th22 cells, but not Th1 and Th17 cells. Moreover, plasma IL-22 levels as well as peripheral Th17 and Th22 cells correlated with SLE disease activity index (SLEDAI) scores and erythrocyte sedimentation rate (ESR). High frequencies of plasma IL-22 autoantibodies were detected in new-onset SLE patients. However, IL-22 levels did not correlate with IL-22 autoantibody. Decreased plasma IL-22 levels and correlation with Th22 cells may be distinct features in new-onset SLE. Moreover, IL-22 and Th22 cell correlated with SLE disease activity.